Saturday, September 28, 2013

Estimated Rates for Health Insurance - 2014

How much will I pay for ACA (Obamacare) health insurance in 2014?

We do not expect accurate prices from the govt until December 2013.
The ACA (govt) quoting system is not working right (yet).

The most-accurate prices available are from BCBS-Tx.
There's a quick Tax Credit Estimator here:

Just run-a-quote & look for the "Estimator" button.

Your estimated premium tax credit will:
- Instantly appear on your screen
- Be deducted from the BlueCross rate quotes.


If you'll save (at least 1 of) your BlueCross quotes:
- You won't need to type-in dates-of-birth (etc) again later
- You can log-back-in later

Just write down your:
- User Name
- Password
And, your next visit will be fast.

Cigna has removed their Tax Credit Estimator.
They'll add it soon as they are sure that they are retrieving accurate numbers from the govt.

Cigna is offering a SILVER Plan with a ZERO deductible (for 2014).
It should be very, very popular!
You can check out the prices NOW (for Cigna plans effective 1/1/14).
Just use the Cigna Quotes link (above).

None of the other health insurance companies are offering Premium Tax Credit Estimators (yet).

Our Instant Online Quote Engine will ...when we can trust the govt figures...
...probably in December 2013.
It will compare ALL of the 2014 plans for you side-by-side...

Your 2014 premium tax credits (subsidies) will be based upon:
- Household size (on your federal tax return)
- MAGI (on federal tax return)

Household size:
Will be based upon family size ON your federal tax return

If you claim no dependents on your tax return:
Household size = 1

If you & your spouse file a joint tax return & claim NO children:
Household size = 2

If you & your spouse file a joint tax return & claim 2 children:
Household size = 4

If your mother-in-law lives with you, but you don't claim her (as a dependent) on your tax return; she is not included in your "household size" for the ACA (govt) calculations.

MAGI - Modified Adjusted Gross Income
Based upon the numbers on your federal tax return

For most taxpayers, this will be:
- Line 37 on Form 1040 (tax return)
- Line 21 on Form 1040A
- Line 4 on Form 1040EZ

The tax credits can be paid directly to your insurance company each month (in 2014). can just take the full "annual" credit at end-of-year (on your 2014 tax return).

Your ACA tax credits for 2014 will ultimately be based upon your MAGI for 2014 (the figure on your 2014 tax return that you'll file in 2015).

But, you can use:
- 2012 Tax return a guide
- 2013 Income an estimate


If your MAGI is different (in 2014), it will simply be reconciled on your 2014 tax return (that you'll file in 2015).

If your tax credit (taken each month) was too LOW:
- You'll get the additional credit (refund) on your 2014 tax return

If your tax credit was too HIGH:
- You'll pay the govt back with your 2014 tax return***

***There's a limit (a cap) on how much you're required to pay them back.
It's based upon your FPL% (Federal Poverty Level percentage)


See IRS Q&A - Premium Tax Credits at link below for more details:

Repayment caps are explained (& outlined) here:


For a single taxpayer...with income under 200% of FPL (an annual income under approx $24,000 in 2014):
- $300 is the maximum you'd have to pay them back (if you took too much credit during 2014)

FPL (Federal Poverty Level) Chart for 2013:

FPL charts for 2014 are not available yet.

October, 2013 
The govt will not use the 2014 FPL determine your tax credits for 2014 health insurance plans.
They'll use the 2013 FPL charts (unless this changes again).

The Instant Online Quote Engine on our website ( will figure your govt subsidies (monthly tax credits for 2014) for you...
........beginning in December(?) 2013...when it can retrieve accurate numbers from the govt system.

It will compare plans (health insurance policies...from ALL of the insurance companies) for you........side-by-side.

You can even compare up-to 4 plans in more detail...side-by-side.
You can email your favorite choices to yourself.

There will be links to see if your doctors (& hospitals) are in the networks.
Then, you can pick-a-plan (that you like best).
Our system will transfer you to the ACA (govt) application (to complete your forms online).

You can pay your 1st monthly insurance premium:
- With a check, money order, credit card, debit card, bank draft (& more)
- With your application (in advance).....or later (by mail)

For those who use the govt system (to get your tax credits applied monthly):
- Your 2014 ACA health insurance policy will not be effective (activated) if your part of the payment is not received before the effective date of the policy

This is only a very brief summary of the rules (laws).
There are millions more (rules, regulations, clarifications, etc).
There are also many exceptions to the rules.
And, more changes & clarifications (to the ACA law) are written every week.

Our Instant Online Health Insurance Quote Engine is here:

You can buy a 2013 health insurance policy (at above link) now ...
...before the 2014 price increases...
...if you are in good health.

The 2013 policies will not offer (include) govt subsidies (the monthly tax credits).
Tax credits will only apply for the NEW ACA-compliant policies purchased for 2014.

You can keep your 2013 policy until December 2014... most Texas......if you want to do so...
...due to a loophole in the ACA law.

Or, you could cancel your 2013 policy effective 12/31/2013.
(You might decide that you do want a new ACA-compliant policy for 2014.)


Each insurance company will send out (is sending out) notices...
...letting you know what to do...
...if you want to keep your 2013 policy until December, 2014.

Most of the letters will simply say:
- There's nothing for you to do.
- We'll be extending your 2013 health insurance covg to Dec 2014.
- Just call us if you want to cancel your 2013 policy (& give us your requested date-of-cancellation).

Update:  October, 2013

We are seeing:
- Much higher prices for 2014 health plans (than 2013 plan prices)
- Much smaller networks (for many of the new 2014 plans)
- New HMO plans
....for individuals & families

HMO Plans were rare in the individual/family market in Texas.
They've been more common in the group market (employer covg at work).

The cheaper choices (in 2014) will be HMO Plans.

HMO Plans:
- Offer no coverage out-of-network (except for certain emergencies)
- Do not work well for those who travel out of their HMO area
- Do not usually include every hospital in your area
- Have much smaller networks (than PPO Plans)

The new quotes (for 2014) will be much more complicated than you've seen in the past.
You must watch for HMO's if you:
- Travel (outside of your city)
- Have certain doctors/hospitals that you prefer

I hope this information is helpful ...
... and not too confusing!

For more details (and there are many), please consult:
- The ACA law
- Your attorney
- Your licensed tax accountant
- Your licensed insurance agent (...that would be us)
....If we're not your agent, we'll be happy to become your agent.

I've provided this information (in my own words) to help simplify the rules for you.
It is not intended to be legal (nor accounting) advice!
I have an accounting background; but I'm only a licensed health insurance agent (for the past 30 years).
I have earned a formal certificate from the federal govt to offer (sell) the new ACA-compliant health insurance plans for 2014.

I've spent hundred & hundreds of hours studying this new law (so that I can be the best agent possible for my clients).

We are here to help you!
Our services are offered at no extra cost to you.
We are paid by the insurance companies (based on the business we send to them).  
We never sign any contracts that require production quotas!  
We recommend the insurance company (and policy) that's right for you & your family.

Ruth Stewart
Texas License Number:  1012551

For 2014 ACA applications:
NPN (National Producer Number):  1103110
FFM User ID:    123777

These last 2 numbers will be requested on your govt application.

Best Health Insurance Rates in Texas 

Link to our blog:  Why buy a new health insurance plan for 2014?



Premium Tax Credit Calculators (used before BC estimator was available):

Kaiser APTC Subsidy Calculator:

Lets you enter your state (probably more accurate than Berkeley).


Berkeley National Calculator:


ACA = Affordable Care Act (the Obamacare law)
PPACA = Patient Protection & Affordable Care Act (the Obamacare law)

PTC = Premium Tax Credit
APTC = Advanced Premium Tax Credit

Tips for successful use of the govt website:

Grandfathered health insurance policies = Purchased before the ACA law was signed (on March 23, 2010)

ACA details about Grandfathered Plans (policies):

Grandfathered vs Non-Grandfathered Plans explained here: